Antiepileptic Drug Treatment Outcomes and Seizure-Related Injuries Among Adult Patients with Epilepsy in a Tertiary Care Hospital in Ethiopia

Figures & data

Table 1 Socio Demographic Characteristics of Patients with Epilepsy Attending the Neurology Clinic of Tikur Anbessa Specialized Hospital, 2017

Variables		Number (n)	Percentage (%)
Sex	Male	154	52.9
	Female	137	47.1
Age	Adolescent (<18)	39	13.4
	Young adult (18–30)	146	50.2
	Adult (31–60)	99	34.0
	Elderly (>60)	7	2.4
Marital status	Single	185	63.6
	Married	97	33.3
	Divorced	5	1.7
	Widowed	4	1.4
Residential area	Urban	238	81.8
	Rural	53	18.2
Educational status	No formal	16	5.5
	Primary	88	30.2
	Secondary	105	36.1
	Tertiary	82	28.2
Occupation	Unemployed	112	38.5
	Employed	69	23.7
	Private/trader	49	16.8
	Student	50	17.2
	Daily laborer	2	0.7
	Farmer	6	2.1
	Others^a	3	1.0

Note: ^aPension

Table 2 Clinical Characteristics of Patients with Epilepsy Attending the Neurology Clinic of Tikur Anbessa Specialized Hospital, 2017

Variables			Number (n)	Percentage (%)
Types of seizure	Generalized seizure		197	67.7
	GTCS		193	66.3
	Myoclonic		3	1.0
	Absence		1	0.3
	Partial seizure		71	24.4
	Simple partial		19	6.5
	Complex partial		23	7.9
	Partial with secondary generalization		29	10.0
	Unclassified^a		23	7.9
Follow-up years	< 2 years		49	16.8
	2–5 years		53	18.2
	6–10 years		69	23.7
	>10 years		120	41.2
Co-morbid conditions	RVI		20	6.9
	CRVHD/CHF		8	2.7
	Major depressive disorder		10	3.4
	Migraine headache		3	1.0
	Mental retardation		5	1.7
	Hypertension		12	4.1
	Stroke		7	2.4
	Others		14	4.8

Notes: ^a“Unclassified seizure” was seizure which is diagnosed by the physician as “Epilepsy” or “seizure disorder”.

Abbreviations: GTCS, generalized tonic clonic seizure; RVI, retroviral infection; CHF, congestive heart failure; CRVHD, chronic rheumatic valvular heart disease.

Figure 1 Number of Antiepileptic drugs used among patients with epilepsy attending the Neurology Clinic of Tikur Anbessa Specialized Hospital, 2017.

Table 3 Types of Antiepileptic Drugs Prescribed with Corresponding Seizure Type Among Patients with Epilepsy Attending the Neurology Clinic of Tikur Anbessa Specialized Hospital, 2017

Medication Pattern	Types of Seizure
	Generalized Seizure	Partial Seizure	Unclassified	Total
PHB	69	14	10	93
PHT	25	10	0	35
CBZ	12	18	2	32
VPA	14	3	0	17
LTG	1	0	0	1
PHB+ PHT	25	1	4	30
PHB+CBZ	8	5	4	17
PHB+VPA	13	2	0	15
PHB+LTG	1	0	0	1
PHT+CBZ	3	10	0	13
PHT+VPA	5	2	2	9
CBZ+VPA	3	4	0	7
CBZ+VPA+PHB	3	1	0	4
PHB+PHT+CBZ	4	0	0	4
PHB+PHT+VPA	1	0	0	1
PHB+PHT+CLZ	1	0	0	1
Others^a	9	1	1	11
Total	197	71	23	291

Notes: ^aDifferent combinations of the above drugs including four drug combination.

Abbreviations: PHB, phenobarbital; PHT, phenytoin; CBZ, carbamazepine; VPA, valproic acid; LTG, lamotrigine, CLZ, clonazepam.

Table 4 Types and Prevalence of ADRs Identified from Patients with Epilepsy Attending the Neurology Clinic of Tikur Anbessa Specialized Hospital, 2017

Types of Adverse Drug Reaction	Frequency (n)	Percentage (%)
Headache	39	27.1
Depressed mood	36	25.0
Epigastric pain	35	24.3
Gingival hyperplasia	16	11.1
Hypersomnia	28	19.4
Forgetfulness	18	12.5
Weight gain	9	6.3
Confusion	15	10.4
Skin rash	4	2.8
Blurring of vision	7	4.9
Weakness	16	11.1
Others^a	10	6.9
Total	144	100

Notes: ^aOthers include irritability, ataxia, and tremor.

Figure 2 Seizure-free period of participants among patients with epilepsy attending the Neurology Clinic of Tikur Anbessa Specialized Hospital, 2017.

Table 5 Factors Associated with Treatment Outcomes Among Patients with Epilepsy Attending the Neurology Clinic of Tikur Anbessa Specialized Hospital, 2017

Variables	Category	Seizure Status, n (%)		AOR (95% CI)	P-value
		Uncontrolled	Controlled
Adherence status	Non-adherent	98 (76)	31 (24)	1.00
	Adherent	93 (57.4)	69 (42.6)	2.345 (1.41–3.91)	0.001*
Presence of ADR	Yes	100 (69.4)	44 (30.6)	1.00
	No	91 (61.9)	56 (38.1)	0.65 (0.38–1.03)	0.061
Number of AEDs	1	90 (52.6)	81 (47.4)	1.00
	2	80 (82.5)	17 (17.5)	0.28 (0.15–0.54)	0.00*
	>2	219 (91.3)	2 (8.7)	0.20 (0.04–0.98)	0.04*
Major drug-drug interaction	Yes	34 (89.5)	4 (10.5)	1.00
	No	157 (62.1)	96 (37.9)	0.33 (0.10–1.12)	0.31
Age category (years)	<18	28 (71.8)	11 (28.2)	1.00
	18–30	99 (67.8)	47 (32.2)	0.37 (0.129–1.07)	0.46
	30–60	62 (62.6)	37 (37.4)	0.256 (0.089–0.79)	0.57
	>60	2 (28.6)	5 (71.4)	0.135 (0.017–1.08)	0.094

Note: *P<0.05.

Abbreviations: AOR, adjusted odds ratio; CI, confidence interval.